Organization
SHAW PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNELLE NUSPL SHAW PT, MSPT, DPT (PRESIDENT)
(303) 514-9912
Entity
Organization
Contact information
Practice address
1021 STAGECOACH DR, LAFAYETTE, CO 80026-8703
(303) 514-9912
Mailing address
1021 STAGECOACH DR, LAFAYETTE, CO 80026-8703
(303) 514-9912
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
8650
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67301592
—
CO
Enumeration date
03/26/2009
Last updated
10/07/2020
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